Organization
J S VITAMINS AND MORE INC
Active
Other names
HAWTHORNE HEALTH AND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JACK BLEICHMAN (OWNER)
(708) 656-1917
Entity
Organization
Contact information
Practice address
4785 W CERMATZ, CIRCERO, IL 60804
(708) 656-1917
(708) 656-1919
Mailing address
4785 W CERMATZ, CIRCERO, IL 60804
(708) 656-1917
(708) 656-1919
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054016342
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1481453
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/13/2007
Last updated
10/08/2010
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